Industries in single payer countries DO carry at least part of that weight, but it’s in the form of government-mandated payments (sometimes they get called taxes and sometimes something else) which are calculated in the same way for everybody, rather than something each company needs to figure out.
I work in population health management, which involves a lot of healthcare data analysis and reviews of clinical guidelines. My company analyzes risk measures and quality of care being received by a patient and by a client’s total population at large. We just do the data, so we don’t have any pressure to make numbers lower or higher for certain measures.
Wellness fairs have a lot of problems associated, including dispensing outdated or invalid clinical advice, using outdated guidelines, not providing context for tests taken (such as the blood pressure example, above).
But the problem comes with the wellness programs, not necessarily the fairs. Because the fair is the *first *step.
There is pressure on employees to “get their numbers down”, which does lead to additional visits and tests and medication. Yes, this is potentially beneficial to the employee and a long-term savings (though generally after the employee has retired), but it will not be a short-term savings, and companies must understand that. (Too many do not, BTW, based on client questions that I get.)
Wellness programs also do a good deal of cough creative accounting of the numbers. For example, the state of Nebraska claimed a few years ago that its workplace wellness program saved over 500 lives from cancer…when the patients did not have cancer at all, only benign polyps of the colon (which are common among folks in middle and older years).
Al Lewis (one of the originators of the idea of workplace wellness, now a critic at how it’s being carried out) pointed out in one of his books that Nebraska claimed $4.2 million in savings even though only 186 people’s risk declined, and claimed a 3% reduction in use of chronic disease medications even though they diagnosed an extra 40% of the population with a chronic disease needing medication.
This is only one example out of dozens that I can think of off the top of my head. (But it’s late, and I do not want to bore the entire SDMB to death.)
It’s possible that you don’t see it in the IT side of things, but I do know how data is repackaged and massaged before it’s presented to the clients to “prove” savings.
Unless they’re upper management…
That is my impression as well. With the Obamacare mandate and elimination of pre-existing condition restrictions, hopefully this will no longer be a factor.
The ACA has a risk adjustment payment that will offset this.
So if Program A has 10 healthy people and 2 sick people, and Program B has 2 really sick people, 4 people with chronic health problems, and 6 healthy people, an offset payment will be made from A to B to equalize the pool.
It’s complicated, as you’d expect; more details at the link.
Our reporting was pretty much aggregate type stuff, along the lines of saying that according to BMI, W% was underweight, X% was normal, Y% was overweight and Z% was obese. Or that some percentage was potentially diabetic, or smokes, or whatever.
How the customer service and sales people spun that stuff to the clients in terms of savings and/or ROI, I don’t know exactly, but I do agree that it’s probably kind of sketchy, just because it’s all statistically based, and the sorts of people presenting and consuming that information like more solid savings/ROI numbers than a statistical guess as to what might happen in 15 years time.